metastatic bone tumours

Question 1

what commonly metastasises to bone?

Answer 1

primary cancers

Question 2

what is the mneumonic for the common ones?

Answer 2

Pb KTL
(lead kettle)

Question 3

what are the common ones?

Answer 3

breast, prostate, kidney, lung, thyroid

Question 4

how do they clinically present?

Answer 4

pain commonly misdiagnosed as muscle strain, any pain with red flags must be investigated with x-ray initially
pathological fracture

Question 5

what bones are most frequently involved with metastases?

Answer 5

vertebra
pelvis
ribs
skull
femur

Question 6

what investigations are used?

Answer 6

x-ray
bone scan
blood tests

Question 7

what is seen on x-ray?

Answer 7

lytic (bone destruction)
sclerotic (excess bone formation)
mixed

Question 8

what are blood tests looking for?

Answer 8

serum calcium - hypercalcaemia
LFTs - liver mets
plasma protein electrophoresis - myeloma
FBC
U&Es

Question 9

how is it managed?

Answer 9

surgery - regardless of prognosis
skeletal stabilization or joint replacement - risk of impending pathological fracture